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Pathopharmacology I > Wk 1 Pneumonia > Flashcards

Wk 1 Pneumonia Flashcards

1
Q

Define pneumonia

A

ANY type of infection of the LOWER respiratory system

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2
Q

There are many etiologies for pneumonia such as…

A

Fungal, protozoa, viral, bacterial, parasitic

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3
Q

What does pneumonia do?

A

Causes inflammation of the lung tissues, the alveolar air spaces become filled with purulent, inflammatory cells, and fibrin

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4
Q

How is pneumonia transmitted?

A

Inhaled infectious droplets

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5
Q

What season is pneumonia most prevalent?

A

Winter

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6
Q

What gender is pneumonia more prevalent?

A

Males

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7
Q

List 9 risk factors for pneumonia

A

1) Age extremes, elderly or children less than 5
2) Immunocompromised
3) Underlying lung disease
4) Alcoholism
5) Altered LOC
6) Dysphasia
7) Long term care facility
8) Hospitalization
9) Influenza

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8
Q

Pneumonia usually starts as some sort of __ __ __

A

upper respiratory infection

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9
Q

Why is alcoholism a risk for pneumonia?

A

Aspiration risk

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10
Q

Why is altered LOC a risk factor for pneumonia?

A

Aspiration risk

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11
Q

Why is hospitalization a risk factor for pneumonia?

A

Tracheal intubation or LOC issue

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12
Q

What are the two classifications for pneumonia?

A

Community acquired pneumonia and hospital acquired pneumonia

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13
Q

Community acquired pneumonia is one of the most common reasons for __

A

hospitalization

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14
Q

Hospital acquired pneumonia develops within __ hours after admission

A

48 hours

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15
Q

Which classification has better outcomes?

A

Community acquired pneumonia

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16
Q

Hospital acquired pneumonia is typically associated with __ care.

A

ICU

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17
Q

Pneumonia associated with endotracheal intubation

A

Ventilator associated pneumonia

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18
Q

What is the most common route for pathogenesis of pneumonia?

A

aspiration of oropharyngeal secretions

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19
Q

Once the pathogen is in the lower airways, what happens in the pathogenesis of pneumonia?

A

Inflammation causing vasodilation, infection spreads to alveoli

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20
Q

When the alveoli are infected, this causes goblet cells to…

A

secrete mucus between the alveoli and capillaries preventing gas exchange

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21
Q

How does the sputum in between the capillaries and alveoli prevent gas exchange?

A

Alveoli attempt to open and reclose against the purulent exudate but many cannot making gas exchange less than optimal

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22
Q

What three things contribute to the pathogenesis of pneumonia?

A

1) failure to cough reflex
2) Mucociliary clearance mechanism
3) Immune system

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23
Q

What causes the exudative fluid to move into the alveoli?

A

Failure of the mucociliary defense mechanism

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24
Q

Why are smokers at much higher risk for pneumonia?

A

Their mucociliary defense mechanism are already ineffective

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25
Q

What are the symptoms of pneumonia?

A

Fever, chills, productive or dry cough, malaise, pleural pain, sometimes dyspnea and hemoptysis

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26
Q

What is pleural pain?

A

Chest pain with breathing

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27
Q

What type of bacteria is usually found in hospital acquired pneumonia?

A

gram-negative

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28
Q

Bacterial pneumonia is typically acquired where?

A

In the hospital

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29
Q

Viral pneumonia is typically acquired where?

A

In the community

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30
Q

What does someone with severe pneumonia look like?

A

Tachypnea, signs of respiratory distress/failure

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31
Q

People who are in respiratory distress still maintain oxygenation by…

A

increased work of breathing

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32
Q

Someone who is in respiratory failure has increased work of breathing yet…

A

cannot compensate for inadequate oxygenation

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33
Q

What are symptoms of respiratory distress?

A

Tachypnea, nasal flaring, pursed lips, stridor, wheezing, agitation, tachycardia, pale, slow cap refill

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34
Q

What are symptoms of respiratory failure?

A

RR over 60, retractions, grunting, mottling, head bobbing, bradycardia, hypotension

35
Q

What does respiratory arrest look like?

A

Bradypnea, inefficient respirations, cyanosis, no air movement

36
Q

What do wet breath sounds sound like?

A

Rhonchi

37
Q

Sections of your lungs that have a bunch of mucus in them

A

Pulmonary consolidations

38
Q

What do pulmonary consolidations sound liek on percussion?

A

Dullness

39
Q

What do pulmonary consolidations sound like on auscultation?

A

Inspiratory crackles

40
Q

What might someone with pulmonary consolidations have if you are feeling their back?

A

Increased tactile fremitus and egophony

41
Q

What is tactile fremitus?

A

refers to the vibration of the chest wall that results from sound vibrations created by speech or other vocal sounds

42
Q

What is egophony?

A

Change from e sounds to a sound when speaking due to fluid accumulation in the lungs

43
Q

What are diagnostic tests for pneumonia?

A

1) chest x ray
2) CBC with diff
3) sputum for c&S

44
Q

What on a CBC would indicate pneumonia?

A

Leukocytosis

45
Q

What are you looking for on a chest x ray for pneumonia?

A

Infiltrates

46
Q

If bacterial pneumonia is gram positive, it is usually __ __

A

staph aureus

47
Q

What does someone usually get staph aureus bacterial pneumonia?

A

Enters through the blood stream via IV routes and travels to the lungs

48
Q

What is the most common cause of gram positive hospital acquired pneumonia?

A

MRSA

49
Q

What is the most common organism associated with gram-positive community acquired pneumonia?

A

Streptococcus pneumoniae

50
Q

How does someone in the community get streptococcus pneumoniae?

A

They get strep throat and then it spreads to pneumonia

51
Q

Steptococcus pneumoniae cause of pneumonia is often called __ __

A

Pneumococcal pneumonia

52
Q

With pneumococcal pneumonia, the sputum is normally what color?

A

Brown or rusty colored

53
Q

What type of bacteria makes you the sickest?

A

gram-negative infections

54
Q

What are three examples of gram-negative etiologies for pneumonia?

A

Pseudomonas auruginosa, Aceinetobacter, Klebsiella pneumoniae

55
Q

Bacterial pneumonia that is acquired in the hospital is often from a __ __ infection/contamination

A

central line

56
Q

What is aspiration pneumonia?

A

Material from the GI tract stimulated an inflammatory reaction

57
Q

The severity of the inflammatory response to aspirate in the lungs depends on what?

A

The pH of the aspirate

58
Q

The more __ the aspirate the greater the inflammatory response

A

acidic

59
Q

What type of medication decreases the acidity of gastric contents that we give to patients with aspiration pneumonia?

A

proton pump inhibitor

60
Q

Aspiration pneumonia can be __ or __

A

silent or abrupt

61
Q

Most common cause of viral pneumonia

A

Influenza

62
Q

Most common cause of community acquired pneumonia

A

Influenza

63
Q

What do viruses do that puts the patient as risk for secondary bacterial pneumonia?

A

Alter the pulmonary immune defense making lungs vulnerable to bacterial infection

64
Q

With viral pneumonia, what is the prognosis in healthy people?

A

Good, usually improves in 2-3 weeks

65
Q

What is type of atypical pneumonia etiology is most common in HIV-infected persons or transplant patients?

A

Pneumocystis carini pneumonia

66
Q

What type of organism is Pneumocystis carini pneumonia?

A

Yeast

67
Q

What is the etiology of “walking pneumonia”?

A

Mycoplasma

68
Q

Atypical pneumonia caused by mycoplasmas are usually

A

mild

69
Q

What are the symptoms caused be mycoplasma atypical pneumonia?

A

Persistent cough, headache, earache

70
Q

Mycoplasma is a bacteria-like organism and contrains…

A

properties of both bacteria and viruses

71
Q

What type of atypical pneumonia is spread via water systems?

A

Legionella

72
Q

What type of organism is Legionaella

A

gram-negative bacteria

73
Q

Legionella pneumonia can be very __

A

deadly

74
Q

Legionella pneumonia is also called

A

Legionnaire’s disease

75
Q

What do you have to do if a patient is confirmed to have Legionnaire’s disease?

A

Report it to the health department

76
Q

What type of atypical pneumonia is released from walls of old buildings?

A

Aspergillus pneumonia

77
Q

Aspergillus is what type of organism?

A

Fungus

78
Q

Aspergillus pneumonia can be very deadly to those who are __

A

Immunocompromised

79
Q

What are 4 measures to treat pneumonia?

A

1) ensure ventilation/oxygenation
2) Adequate hydration
3) Good pulmonary hygiene
4) Nebulizer treatments

80
Q

What pneumococcal vaccine is the PVC13?

A

Prevents pneumococcal pneumonia caused by 13 strains of strep

81
Q

What pneumonia vaccine is the PPSV23?

A

Prevents against an addition 23 types of pneumonia bacteria

82
Q

You can give PVC13 to __ in a series of 4 doses

A

Infants

83
Q

Both PVC13 and PPSV23 can be given to the elderly if they are not…

A

do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant

Pathopharmacology I (33 decks)

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